Episode 2: Healthy Habits for ChildrenLiving the Healthy Life Podcasts
Brian Hubbard: [00:00.00] Welcome to the Living the Healthy Life Podcast, where we bring you the latest on Health and wellness from the experts here at Lee Health. Discover what is happening in Lee Health and take away tips and inspiration to reach your ideal state of health.
Brian Hubbard: [00:15.76] Hello and welcome. My name is Brian Hubbard; I am the Manager for Marketing and Brand Management at Lee Health. With me, is my co-host Carrie Bloemers, who is a registered dietitian, as well as a Director of Education and Navigation at the Healthy Life Center at Lee Health Coconut Point. long title.. Ah, but it is good. Hello Carrie, how are you?
Caroline Bloemers: [00:36.00] Hi Brian, nice to see you this morning.
Brian Hubbard: [00:39] Good to have everybody with us. So thanks to everyone, like I said, for joining us today.
[00:42] We are privileged to welcome Dr. Denise Drago. She is a pediatric primary care physician at Lee Health, and she is here to talk to us today about children's health. It is a big topic but we want to try to get to some specifics. She wants to offer her expertise on how families can raise healthy children, some general tips, and advice on nutrition, screen time habits, and really anything else that we can think of. So hello Dr. Drago and thanks for being with us today.
Denise Drago MD: [01:10] Good morning. Thanks for having me
Brian Hubbard: [01:12] Thanks for being here. So let's just jump right in. Let's not waste any time.
[01:16] We always like to ask because it helps patients connect with their provider and all that good Stuff. We want to know a little bit about you. Why did you get into Medicine, how did you get into medicine, and how did you decide on pediatric care?
Denise Drago MD: [01:29] So, I think when I was about 5, I told my parents I was going to be a pediatrician and I was going to take care of little babies. So, I've always wanted to be a pediatrician. I think part of that is because I'm the youngest of 3 and they told me I wasn't going to get a sibling so I kind of moved on from there, Um, and then as I went through school, I really did find that I enjoyed medicine and pediatrics. It is just a lot more fun. I think as babies and little kids we’re a lot more fun when we're sick. Adults are not quite as much of a fun time when you are not feeling so good. So having little kids around is always an enjoyable thing, whether they are sick or well they kind of know how to have a good time.
Brian Hubbard: [02:07] That's a good point I never thought about that. I was sick recently, and I was miserable for everyone involved. So, uh, thank you very much. So, let's start in with some specific questions. Uh, this is pretty general but it'll get us get us rolling here. Uh, what are some specific concerns, things you've noticed at your practice, with the children and families you treat. I guess what really seems to be maybe the top health concern, or health concerns that you've noticed, or might want to mention today.
Denise Drago MD: [02:33] So as we're coming out of covid I think there were a lot of things that happened during covid that weren't the best of all health habits. So we were at home a lot more. We were eating things that we wouldn't normally have eaten. We weren't doing the activities we were doing, and so a lot of parents now, are trying to figure out; “How do we reinstate those healthy activities and lifestyle choices we were making before?” Before we were kind of locked at home, and “How do we do all of that while still maintaining the connectedness I think families did experience while they were kind of locked together?” Everybody now. Has more family, you know habits, and family nights, and activities. But, we're now getting back into the swing of also having practices, and games, in school, and all of that.
Brian Hubbard: [03:20] What was one of the main things? Like you… you say, you know those..those unhealthy habits that people might have developed during covid, and how are you talking about? Is it like, because I'm talking for myself here, are you talking about comfort food? Are you talking about just unhealthy, just eating habits, that kind of thing? Is it screen time? What would you kind of say?
Denise Drago MD: [03:36] it was both of those things. There was a need to occupy children that usually would be outside, or in school-
Caroline Bloemers: [3:43] mm-hmm
Denise Drago MD: [03:44] -all day, and now you were home for the entire day, altogether-
Brian Hubbard: [03:47] Right
Denise Drago MD: [03:48] -but you really couldn't go out and do anything, so a lot of kids got more screen time. A lot of kids got more, kind of, mindless snacking and parents just really needed something to occupy them, and then I think everyone needed some time away when you had been together for so long-
Caroline Bloemers: [04:02] mm-hmm
Denise Drago MD: [04:03] -so it was “how do I keep you and your brother from fighting for the next twenty minutes?” so let me just give you the I-Pad, and a snack, and go from there.
Caroline Bloemers: [04:10] and as a parent I can totally relate to everything you've said, and you know, being quarantined as families and parents trying to keep working-
Denise Drago MD: [04:20] mm-hmm
Caroline Bloemers: [04:120] -you do throw all the rules out the window. Um, Screen time or tablets, mom and dad need to take this call, or work, so it was, like, anything goes. And then, they help themselves to snacks, and it's not snack time. It's just that rulebook went out the window. So, as a parent, as even a dietician, it's uh, definitely a walk out of covid, of reestablishing behaviors and the family practice we want.
Brian Hubbard: [04:46] Carrie, You have 3 children?
Caroline Bloemers: [04:48] I do.
Brian Hubbard: [04:49] Do you mind telling us their, their ages?
Caroline Bloemers: [04:51] Not at all. So, I have 3 boys they are, 6 years old, four, and a year and a half.
Brian Hubbard: [04:58] Yikes. Okay, no that's great. So, uh, so you have 3 kids, like you were just saying, those are some of the things that you've… Is there any specific things that you've noticed? Like you just said, how difficult has that been?
Caroline Bloemers: [05:09] It, you know, I mean, even screen time is a good, um, behavior to kind of dig into a little bit because, you know, they, their little brains and mind, like, they can never get enough. So getting that exposure of more, and you probably, Dr. Drago, know the science behind it.
[05:26] um, they're just attuned to it, and they're expecting it, when, when you're walking that back, and trying to place more restrictions, It's tantrums. It's you know, yelling, screaming, um, they're loud about it. They want that tablet or tv. But it's no, you know, “we're gonna go outside,” or “now we have this activity,” that's restarting. Like, we're getting back out into the world, So, um, it just causes that, you know, extra conflict and it's hard. You know, it's ah, it's a load to carry on top of everything else.
Brian Hubbard: [05:53] Yeah and that brings me to my my next question I was going to ask you specifically about childhood obesity the concern over that and how that might relate to screen time. Ah, the 1 of the reasons I wouldn't bring up to the holidays are coming up so like you know everyone's. They're gonna be off school right? Do they still have they're still on the case of school and they're all together in the House. You've got christmas cookies or Holiday meals and all that good Stuff. Can you tell us a little bit about that. Perhaps some tips what can parents and caregivers really do, specifically to ensure healthier more active children? Especially these days?
Denise Drago MD: [06:35] The biggest thing is making it more of a family thing and not just a kid specific thing so most of the families that I take care of, their aren't all obese children in the family. So you'll have one kid who's underweight, and one kid who's overweight, and one kid who's perfect weight, and it just makes it really hard to kind of… We don't want one kid to feel like we're always picking on them and saying you can't eat this; But, your brother can have x, y, or z. So, if we make it a family activity and everyone's eating these things that's helpful that does require that mom and dad also then are happy about vegetables and eat those, and that's one of the things that we try to get parents involved with. Having their kids help cook the things. Having their kids go to the grocery store with them and pick them out, and those are activities that you can do as a family that do occupy time, so hopefully keep you away from Screens and all of the other things. But, most kids are more likely to eat something or at least try it if they were involved in making it, and also having family walks after dinner or activities that you all do together. Kids See those things and think like oh mom and dad really like doing this so I want to do that. It isn't a punishment or something you have to do. It's just a healthy lifestyle change and everyone in the family benefits from that.
Brian Hubbard: [08:00] It's interesting know good.
Caroline Bloemers: Yeah, I can share. Even, you know, I'm a dietician and my children do not eat perfect. They don't like everything. They're still picky eaters. Um, but the example of cooking and sometimes it's as simple as.. they don't like cherry tomatoes; but I love them, I have them in the house and they do love the experience of getting their cutting boards, and using a safe.. like serrated butter knife that can cut through those. They're mangled, and they're not pretty, and it doesn't look great and you know they're
Brian Hubbard: [08:31] but they're Happy. -
Caroline Bloemers: [08:32] They're
Brian Hubbard: [08:33] excited about it
Caroline Bloemers: [08:35] experiencing it, and it's also that message to parents to not get discouraged because they don't eat them every time. It's not, um, they're not eating whole tomatoes yet, tut they're tasting it, or they're playing with it. They're getting more comfortable with it, and I still count that as a exposure, and a win, even at 6 and 4 years old. So it doesn't mean you've even failed if “oh they're cooking and nothing.. they didn't eat any of it.” Um. We have to do it over and over, they need the exposure, they need to see mom and dad eating the vegetables, and even in our house dad's working on that. Um, so it's a all the time, and it's our daily behaviors and that, um, bringing them into the kitchen.
Brian Hubbard: [09:16] Is it like a habit you develop?
Caroline Bloemers: [09:16] Yes–
Brian Hubbard [09:18] they learn that how long it takes to instill that habit.
Caroline Bloemers: [09:21] and a success we've had is even with smoothies, and they will Cram handfuls of spinach in the smoothie and drink it; and so for us that's big. They know we're not hiding spinach. They put it in there themselves.
Brian Hubbard: [09:34] you're going to sneak this foliage into a tropical smoothie?
Caroline Bloemers: [09:34] yeah, but, we're getting that nutrition in and they'll see it on their plates, or Mom's plate, know what it is. Identify it, take a little bite, but they like it in their smoothies.
Denise Drago MD: [09:45] and it makes it different colors and different things that make it exciting. So a lot of kids will do like hulk smoothies, which are green, -
Brian Hubbard: [09:54] Oh yeah?
Denise Drago MD: [09:55] or muffins, and there's ways to kind of help them be excited about the things we think they're not so excited about. Even just playing with the food, they've done a lot of studies that show that, that's kind of the first step to getting a child to actually eat it. If I can. You know it's a win to even have some kids let the broccoli be on their plate. They don't actually have to eat it, and that as a parent can seem really frustrating. “I've put it on your plate a hundred times, like you just don't like it.” But the more often that happens, it may end up in another food you like and you accidentally ate it and then you realize “hey I really do like it.” So it's more exposures that they have, the better off they are. You just as a parent can't get too discouraged and too wrapped up in, “you know I serve it every day and you never eat it.”
Brian Hubbard: [10:40] There might, you know, we've come a long way. Maybe? Tell me if I'm wrong? Back in the day, when I was a child, nothing against my parents, but you know everybody at that time it was like you, you put something on a plate and they like; make you eat it. If it's like peas, I know, I remember I really hated peas, or whatever it is; squash or something, something icky. So they'd make you, they would make you eat it “or you're not leaving the table until you've eat it.”
Denise Drago MD: [11:03] right?
Brian Hubbard: [11:04] That kind of thing so we've gotten. We've progressed from those days
Denise Drago MD: [11:08] Absolutely
Brian Hubbard: [11:09] so that is probably not the best way to do it. You know? Again, nobody, we didn't have all this information, perhaps at that time, correct?
Denise Drago MD: [11:16] and I think there was a lot more boiled vegetables, and when you talk to adults about vegetables, and how they were served, you know, we wouldn't like it either. So we also talk about other ways that you could make something that's different, and letting kids realize that you know boiled broccoli taste one way, but, if I put it in the oven and roast it, it tastes a different way. if I put it in Macaroni and cheese -
Brian Hubbard: [11:36] So Good
Denise Drago MD: [11:38] - it tastes a different way. Exactly, and so you may not like it one-way. But maybe, we just need to work on figuring out how you like it.
Brian Hubbard: [11:45] perfect. Yes.
Caroline Bloemers: [11:46] and then instead, as a parent, you know we make a big deal about “Mmmm this is so good, and this is enjoyable,” and then we'll even talk a little bit about, you know, the carrots. They're good for your eyes, and these boys, they want to be able to have night vision like the superheroes. So at least one carrot for each eye, or you know, you're not going to get that night vision, or it helps them see the lizards who are camouflaged in the mulch. So you know, we have these almost educational pieces that we're throwing in like, “hey it's really good for you and this is how it's gonna. Benefit you,” so we'll talk about little things with carrots, or whatever it might be.
Denise Drago MD: [12:22] and I think that leads into conversations that, a lot of times - we are very as adults, focused on weight, and “I don't want to eat that because it's going to make me fat” or, things that we say in front of children, that maybe we shouldn't. So we try to reframe that conversation about what things can we eat that would help you run faster? Or, if you play soccer, you know, you'll be able to last the whole game. Um, we talk about healthy fuel, that you - if you don't put gas in the car, the car won't run. So you have to put good fuel in your body, so that your body can do, what you need your body to do. That, I think helps reframe that conversation about this food, is you know, too fattening or isn't good for you, into something that's a little bit, easier for kids to understand. But also, doesn't have that negative connotation which we're trying really hard to get away from.
Brian Hubbard: [13:13] Exactly. It used to be. Yeah, we've turned a negative into a positive and trying, like you said reframe. I like that.
[13:20] Okay, good so shifting gears real quick. So let's go to, you Dr. Drago, you you practice at Lee Health Coconut Point.
Denise Drago MD: [13:28] Mmhm
Brian Hubbard: [13:29] So, one of the things I wanted to ask, was; What should parents and children expect at a doctor's appointment these days? How is the, speaking about how things have changed, I'm assuming they’re a lot more different, then they were than when I was a child, perhaps? So why is it important to establish care with a pediatrician? What can parents and and children expect when they come see you?
Denise Drago MD: [13:49] I think the biggest thing, I mean obviously with Covid, there's a lot that's different. We try to make things for kids, as comfortable, as possible and we try to involve a lot of the talk about, you know, consent; and what you are allowed to do, and what you have to kind of agree to, as we do those physicals. So when I do physical exams, we talk to children about what we're checking and we check all parts of your body, and if it ever makes you feel uncomfortable, you can always tell us to stop, and we can explain things. So we try to make it as easy as possible. We do talk about those harder things, so I do say -you know- we're going to give you some shots today. But, we try to encourage the more positive part of -you know- these shots will help you, so that you don't get sick in the future, and help kids kind of process that.
[14:48] One of the big things that we really emphasize to kids is, I'm never going to lie to you, so if something's going to hurt, I'm going to tell you that this is going to hurt -or, if it's going to feel funny, or if it's go to tickle. We try to show them what we're going to do, before we do it. I really try to have kids touch all of the things first. So when we look in their ears, I always have them touch the light that we use just to show them it doesn't hurt -It's not hot. A lot of times, we as adults, think that kids are overreacting, but if someone was coming at you with something that you've never seen before it's very scary.
Brian Hubbard: [15:23] get away from me.
Denise Drago MD: [15:24] -and so if we talk to you about it, we are able to kind of, get kids to be compliant and they are enjoying things. I have a lot of kids who bring in their own little doctor kits and we will -kind of- go back and forth. Where, they will listen to my heart and I’ll listen to their heart, so they are getting to participate in the visit. Then when I ask the questions, as soon as children are really able to even interact, we are having that conversation with them, and their parents, -because it's their health- and we're not making decisions for them. We want to be making decisions with them.
Brian Hubbard: [15:58] Excellent. So they get to feel like, it kind of, -well maybe I'm stretching, but it kind of goes back to what you guys were talking about with the food; if they feel like, they're a part of the process and not just sitting there as someone who's being, -something's being forced, and you have to do this, and it's not gonna feel good, and all that. So it's the same -kind of- open, collaborative conversation, and they get kind of excited about it.
Denise Drago MD: [16:18] They do. And then kids get very used to what I say during visits, and what I said the last time, and that to me is -kind of- the joy of having a relationship with families. So we like when kids are coming back, year-after-year, because I know, them they know me -and things get easier the longer you're there. Um, and most parents they, -you know- think their kid is the only one who screams when things happen, or just has a fit, -I think for parents, it's nice when you know they hear the kid next door doing the same thing.
Brian Hubbard: [16:51] I was just thinking that.
Denise Drago MD: [16:53] so we say a lot of times, like this is very typical for their age -and we kind of work around what we can do to make things as comfortable as possible. So, we may not examine you on the exam table, because that, just isn't what you want to do that day. So I try to give kids -even when they're really little, choices so they feel more in control of what's going on.
Brian Hubbard: [17:15] It seems like it's a lot less formalized, than maybe it was -again just using myself as an experiment experience, so that sounds really -almost makes you want to go to the doctor. So that's -and that's the whole point. Right? I mean you want them to feel comfortable and then they become, you hope, patients for life. You know? -And you, you learn their habits, and they have healthy habits Instilled from them at a young age. Correct?.
Denise Drago MD: [17:35] Mhmm
Brian Hubbard: [17:37] That's good
[17:39] and Carrie, so I was thinking about you when she said that. How is your experience with 3 children at the doctor? You don't take them all at once I am assuming?
Caroline Bloemers: [17:45] Oh! Well.. we've tried it both ways. Um, and you know you want to cut out a trip, but I think it's the relationship that Dr. Draggos spoke of, so you keep those well visits -those annual checks, and then when you do have to go in when there's something going on. Um, they are aware of where they're going and this person's there to help when they're already feeling sick and vulnerable-
Brian Hubbard: [18:11] Right
Caroline Bloemers: [18:12] So that relationship's important; and then as a parent having the um you know the my chart portal and being able to message and speak to the provider or the office -
Brian Hubbard: [18:22] that's a good point
Caroline Bloemers: [18:23] been a huge benefit of you know, being a patient and experiencing the advancements of technology so we can get questions answered we can send pictures of rashes
Brian Hubbard: [18:34] Wow
Caroline Bloemers: [18:35] and things that are you know. You just don't want to rely on Dr. google. You want the actual expert-
Brian Hubbard: [18:41] this is true
Caroline Bloemers: [18:42] to weigh in there.
Brian Hubbard [18:43] It's very true.
[18:44] Okay, so I want to go back to healthy snacks really quick, only because the holidays are coming up and I'm very curious as to what you guys would consider, healthy and tasty snacks that kids might enjoy? Because, when I think of the holidays, I think of cookies and all that good stuff which I know is neither bad nor good. But, I know it's not good for you. So what are some healthy snacks that you think kids would enjoy that would taste good and be nutritious at the same time?
Denise Drago MD: [19:10] So I would always start with a fruit or a vegetable. It just seems to be something that kids really do like, - especially the fruit part, and then you can add different dips or different decorations to it, to kind of make it more fun and enjoyable. Most kids would be more than happy with some sort of fruit, or even like a vegetable with dip, or if you cut up a different, few different ones, You can have kind of a platter of different ideas that they could kind of pick and choose from.
Brian Hubbard: [19:39] Because fruit is good. Because like you said kids, kids like fruit, but they may not I mean, it's it's good. Carrie, what what do you think? I know you probably have used the fruit method.
Caroline Bloemers: [19:48] Yes I agree and with the ages of our children. The choice aspect is really important, so offering “do you want grapes or a little cutie, -like a clementine” so they have some control over the situation. So, we typically allow that choice with which fruit that would they like. Then we also have, you know, uh, a bin that has various healthier versions of say.. like a bar, or pretzels, or something that's in our snack regiment. At a snack time, or if we're packing to go the park they can choose what they're going to bring. So keeping them in that normal routine, I think is also important through the holidays; and there will be special treats, and we still want to create a healthy relationship with food, not restrictive or labeling everything as Bad. So just like you and I will all have a few treats this Holiday season, so -
Brian Hubbard: [20:44] I’ve has some this morning already.
Caroline Bloemers: [20:45] Yeah, so we don't want to pass on any of those like restrictive or unhealthy relationships we have with food to our children. So allowing them a treat on those special occasions or when they are at a party, you know we don't want to see a plate, full of just treats. We've hopefully are teaching them along the way how to create that healthy plate that has a little bit of everything and they can pick an item. So it's also, you know, allowing that as part of the experience, um, and that's kind of how we see it as well. So maybe that will be an experiential thing that we have when we're out or at a party, but we're not necessarily bringing all that into the house, just because.
Brian Hubbard: [21:21] Right, that makes sense.
[21:23] Well that sounds really good, Dr. Drago, can you tell us real quick, -as we wind up here, I've got a note here about well child checkups, can you tell me a little bit, about what that is? Because, and the reason I bring it up is because, I know it is a term that I am seeing a lot more. It is a term that people are using in marketing and advertising. Can you tell us a little bit about what that is, and what that might mean to parents and families?
Denise Drago MD: [21:46] So, the well child checkup is something that we do mostly every year -but when you're younger, we do them a little bit more frequently. It's the time where you meet with your pediatrician so that you can talk about what your child is doing, how your child's growing, how they're eating and sleeping. We took… We sort of take a look at their growth chart, we take a look at their diet, and different developmental concerns that you may have, or that they may not be quite meeting their goals, or they may be exceeding the goals, and we will then address kind of what's coming up next. So we talk about anticipatory guidance, so in the next year I would expect your child to be doing this, and this, and -you know- if this issue comes up this is what we would recommend. Or we see that you're really struggling with sleep, so here's some recommendations we would make on how to help with that. Then as the children get older, we talk to them about school, friends, and different stressors that are going on in their life. A lot of times, that's where kids will ask questions about either how their bodies are changing, or how their friend circles are changing, and then they're really able to get the information and the advice that they want, and kind of learn how when you go to the doctor as an adult how to bring up a question and how to get the answers that you need for your own health.
Brian Hubbard: [23:13] That's pretty interesting because it goes beyond, and the thing we always try to stress is that it goes beyond physical health. You're talking about things that affect them emotionally, things that affect them mentally, that's all a part of… are you're seeing sort of a… it seems like we're getting a little more comfortable talking about those things, as a society, in general, I'm, I'm assuming? I'm seeing a little bit of that. Is that what you're seeing, people are more comfortable, and they want to talk more about those things, because those are things that affect us every single day is that right?
Denise Drago MD: [23:41] So we try very hard to stress to kids that they can talk to us about anything-
Brian Hubbard: [23:45] Right
Denise Drago MD: [23:46] and that we are a source of accurate information. That maybe, they feel, they're not getting the best information from their friends, or -
Brian Hubbard: [23:58] Right
Denise Drago MD: [23:59] things like that, where a lot of times, parents especially at puberty feel kind of at a loss on how to answer some of those things –
Brian Hubbard: [24:05] Right
Denise Drago MD: [24:06] and so coming to the doctor and having us address it, as a family, where I can kind of help parents guide them through talking to kids about it, and answer those questions is helpful. Then we always ask kids at all of our checkups -You know- “what do you worry about, things, and we do a depression screening as kids get older. Just to kind of open up that door, to this is something that is just like your physical health. It isn't as knowledgeable in the general public that we are addressing it that way. So
Brian Hubbard: [24:40] Right
Denise Drago MD: [24:41] sometimes we say like oh if you break your arm, you would go to the doctor. But, if you don't -you know- feel happy, that's a different problem, and not something that you would go to your doctor. We really want kids to be able to come to us and talk about those things, and a lot of times we're able to fix that, or at least give them ideas and advice on how we can make that better.
Brian Hubbard: [25:01] That's perfect. I mean that's the thing about what you do. The thing about what Lee Health tries to do, is that it's for the whole, the whole person. Like you said, you can go talk to your primary care doctor, should be like your first, -you know- your first point…. your first point contact and that from that point you can go out to whatever the child or anybody else may need.
Denise Drago MD: [25:21] yes
Brian Hubbard: [25:22] well that's great!
[25:23] Carrie, I'm going to throw it to you for one final input on anything to you have, we're about out of time, so I wanted to make sure that I didn't leave you out.
Caroline Bloemers: [25:30] Oh thanks! No, I think um, it's been great to hear Dr. Drago speak about the well visits, child behaviors, things we can do as families, and just to you know, reiterate as a parent, you know we also have all these pressures. The way we should be doing things, and a lot of expectations. So it's -you know- it's also finding that rhythm for your family, the things that work for you. What works for me or the things we shared today, might not be exactly what works for your family. But that doesn't mean it's wrong or that we're doing it Better. So I think there's a lot of comparison, a lot of stress out there, parents feel it and then it kind of trickles down to the kids. So, I think parent-to-parent I would just say, it's not a comparison game. We are all doing the best we can. Just keep trying things, like it is an important focus and can make a really healthy family, so to keep it as a focus, and find what works for you, your kids, your family.
Brian Hubbard: [26:32] Thank you both for being here, so much. Carrie, Dr. Drago, it's been a pleasure having you.
[26:37] A reminder to our listeners, Dr. Drago and other providers at Lee Health Coconut Point are currently taking appointments. We have a new and improved find-a-doctor page on leehealth.org, where you can see appointment availability, as well as learn more about services at Coconut Point, and basically any Lee Health location around the region. Please feel free to reach out to Lee Health Coconut Point directly at 239-468-0000. Is that correct? Catchy phone number 239-468-0000. We hope you tune back in for upcoming episodes. We'll be interviewing experts around Lee Health so you can learn more about what we do, and how we strive every day to fulfill our mission to the community to provide the best care close to home. So thanks for listening everybody, and have a great day.